Healthcare Provider Details

I. General information

NPI: 1164248621
Provider Name (Legal Business Name): BRIDGE TO HOPE HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 NW 56TH CT
OCALA FL
34482-5563
US

IV. Provider business mailing address

631 NW 56TH CT
OCALA FL
34482-5563
US

V. Phone/Fax

Practice location:
  • Phone: 352-497-7816
  • Fax:
Mailing address:
  • Phone: 352-497-7816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: AUDREY BELL
Title or Position: MANAGER
Credential:
Phone: 352-497-7816